Table 2.
Characteristics and Relative Contributions of Synthesized Publications
| Perspectives and sampling timeframe | Author | Year of publication | Research question(s) | Recruitment setting | Recruitment strategy | Qualitative data collection | Methodological orientation/approach to analysis | Percent of all coded quotes |
|---|---|---|---|---|---|---|---|---|
| Inpatient specialist palliative care providers (physician, nurse, nurse technician, chaplain), 2020–2021 | Boger | 2022 | To know the multidisciplinary palliative care team’s perception about stressors in the death and dying process | Brazil, hospitals | Convenience sampling | Semi-structured interviews | Content analysis | 1.12 |
| Inpatient specialist palliative care providers (physicians, nurses, healthcare assistants, senior manager, clinical manager) 2020–2021 | Bradshaw | 2022 | To explore the experiences of and impact on staff working in palliative care during the COVID-19 pandemic | UK, organizations providing specialist palliative services | Purposive sampling | Semi-structured interviews | Thematic analysis | 3.45 |
| Inpatient specialist palliative care providers (physicians, nurses, nursing assistants), not reported | Butkeviciene | 2021 | To understand professionals’ attitudes, experiences, and suggestions concerning end-of-life (EOL) dignity to provide knowledge upon which efforts to improve EOL care can be grounded | Lithuania, members of the Lithuanian Society of Palliative Medicine | Purposive sampling | Semi-structured interviews | Phenomenology, thematic analysis | 1.95 |
| Inpatient specialist palliative care providers (physicians, nurses, medical social worker, spiritual care provider, other), 2020 | Chan | 2021 | To examine the mental health of palliative care professionals in Hong Kong during the COVID-19 pandemic, the relationship of mental health with socio-demographic factors, and the impact of the pandemic on palliative care services | Hong Kong, public hospitals | Snowball sampling | Online survey | Thematic analysis | 0.53 |
| Inpatient specialist palliative care providers (chaplain, social workers, advanced practice nurses), 2020 | Currin-McCulloch | 2021 | To describe an innovative social work and nursing approach to brokering patient and family care amidst the social distancing and visitation restrictions of COVID-19 | USA, level 2 trauma center | Purposive sampling | Open-ended journal prompts | Thematic analysis | 1.95 |
| Inpatient specialist palliative care providers (nurses and nursing technicians) 2020 | deAzeredo Siqueira | 2021 | To identify the main stressors of the nursing staff in assisting patients in oncology palliative care with suspicions and confirmed for COVID-19 and to provide subsidies for measures of psychological interventions during the pandemic by COVID-19 and in the future | Brazil, hospital unit specialized in palliative oncology care | Convenience sampling | Semi-structured interviews | Psychodynamics; Christophe Dejours | 2.03 |
| Inpatient specialist palliative care providers (nurses, physician, psychologists, physiotherapists, spiritual support workers), 2020–2021 | DeLuca | 2023 | To understand the experiences of palliative care professionals deployed in supporting emergency and critical care staff during the COVID-19 first and second pandemic waves | Italy, urban hospital | Convenience, purposive, and snowball sampling | Semi-structured interviews | Thematic analysis | 3.67 |
| Inpatient specialist palliative care providers (physicians, nurses, social assistants), 2020–2021 | Figueiredo | 2021 | To capture the performance of the palliative care team in relation to patients with COVID-19 | Brazil, tertiary public hospital | Purposive sampling | Semi-structured interviews | Bardin’s thematic categorical analysis | 1.81 |
|
Inpatient specialist palliative care providers (physician, nurse practitioners, nurses, fellows, social workers, chaplains), 2020 |
Finuf | 2022 | To investigate how job resources and personal resources reduced perceptions of burnout and increased perceptions of well-being in palliative care teams | USA, urban academic hospitals | Purposive sampling | Anonymous electronic survey | Not reported | 0.26 |
| Inpatient specialist palliative care providers (physicians), 2020–2021 | Fish | 2022 | To explore the narratives of palliative care doctors working during the pandemic to understand their experiences at a personal and professional level | Scotland, hospice providing specialist inpatient and community-based palliative care | Convenience sampling | In-depth narrative interviews, video calls | Paradigmatic narrative analysis | 4.08 |
| Inpatient specialist palliative care providers (chaplains), 2020 | Galchutt | 2022 | To qualitatively capture the perceptions of inpatient palliative care chaplains and the patient–family experience as the pandemic emerged | USA, urban hospital | Convenience sampling | Semi-structured telephone interviews | Thematic analysis | 1.93 |
| Inpatient specialist palliative care providers (mesothelioma clinical nurse specialist), 2021 | Gardiner | 2022 | To explore perspectives of Mesothelioma clinical nurse specialists on their role in providing palliative care for patients with mesothelioma and their families | UK, Mesothelioma UK | Purposive sampling | Focus groups, interviews | Thematic analysis | 2.65 |
| Inpatient specialist palliative care providers (administrative, physician, nurse practitioner, consultant, spiritual worker), N/A | Holdsworth | 2022 | To understand how the pandemic impacted the implementation of new and existing palliative care programs in diverse hospital systems using the dynamic sustainability framework | USA, tertiary academic hospital | Not reported | Semi-structured interviews | Thematic analysis | 1.62 |
| Inpatient specialist palliative care providers (nurses), 2020 | Johnson | 2023 | To explore the caring experiences of palliative care nurses during the COVID-19 pandemic | Qatar, tertiary academic hospital | Purposive sampling | Semi-structured interviews | Content analysis | 2.10 |
| Inpatient specialist palliative care providers (nurse), not reported | Kirby | 2021 | To identify the main psychological influences on the perception of the Nursing staff in oncological palliative care during COVID-19 pandemic | Brazil, hospital specialized in oncological palliative care | Purposive sampling | Semi-structured interviews | Psychodynamics; Christophe Dejours | 1.13 |
| Inpatient specialist palliative care providers (physicians, nurses) 2020 | Luckett | 2021 | To solicit descriptions of, and responses to, ethical issues experienced as a result of COVID-19 related circumstances from the perspectives of nurses providing palliative care | Canada, specialist palliative care services (hospital, hospice, long-term care, community) | Purposive sampling | Video conferencing interviews | Thematic analysis | 0.22 |
| Inpatient specialist palliative care providers (nurses, nurse practitioners, practical nurse), 2020 | McMillan | 2021 | To solicit descriptions of, and responses to, ethical issues experienced as a result of COVID-19 related circumstances from the perspectives of nurses providing palliative care | Canada, specialist palliative care services (hospital, hospice, long-term care, community) | Purposive sampling | Video conferencing interviews | Thematic analysis | 2.39 |
| Inpatient specialist palliative care (physicians, nurses, social workers), 2021 | Okyere | 2022 | To explore palliative care providers’ perspectives on delivering PC services in the era of COVID-19 | Ghana, tertiary teaching hospital | Purposive sampling | Online survey | Content analysis | 3.30 |
| Inpatient specialist palliative care providers (residents), 2021 | Pfieifer | 2022 | To streamline clinical care and communication and improve patient and family experience through the integration of a Palliative Care Practitioner to a COVID-19 specific internal medicine physician team | USA, tertiary acute care teaching hospital and level 1 trauma center | Not reported | Semi-structured interviews | Not reported | 0.10 |
| Inpatient specialist palliative care providers (unknown), 2020 | Pastrana | 2021 | To explore how the COVID-19 pandemic has impacted palliative care workers around the world and describes the coping strategies they have adopted to face their specific situation | Global, IAHPC members | Purposive sampling | Free test questions — survey | Thematic analysis | 1.88 |
| Inpatient specialist palliative care providers (palliative program leaders), 2020–2021 | Rogers | 2023 | To explore palliative care program leaders’ perceptions of the future viability of their programs in the context of the pandemic and inform future educational and program development | USA, any specialist palliative care setting (hospital-based, home-based, other) | Purposive sampling | Online survey | Content analysis | 1.35 |
| Inpatient specialist palliative care providers (physicians, physician assistants, social workers, nurse practitioners) 2020 | Rosa | 2022 | To explore the experiences of an interdisciplinary palliative care team in meeting the holistic needs of oncology inpatients via telehealth over a 10-week period during the first COVID-19 surge | USA, urban comprehensive cancer center | Purposive sampling | Semi-structured interviews | Thematic analysis | 4.39 |
| Inpatient specialist palliative care providers (physicians, physician assistants, social workers, nurse practitioners) 2020–2021 | Rosa | 2022 | To explore the experiences of a multidisciplinary palliative care team delivering tele-palliative care for oncology inpatients during a 10-weeks COVID-19 surge in New York City | USA, urban comprehensive cancer center | Purposive sampling | Semi-structured interviews | Thematic analysis | 2.90 |
| Inpatient specialist palliative care providers (physicians, nurse practitioners, social workers, chaplains, advanced practice nurses), 2020 | Rowe | 2021 | To qualitatively explore the challenges presented by the COVID-19 pandemic from the perspective of palliative care clinicians. Specifically to (1) describe the strategies adopted by palliative care clinicians to cope with new challenges including patient and clinician isolation, prognostication of an emergent disease, and rapidly rising numbers of severely ill patients and (2) identify additions or adjustments to in-person and system-related palliative care training, methods, and tools made during pandemics | USA, specialist palliative care services (palliative care clinical sites, hospitals, academic medical centers) | Purposive sampling | Semi-structured interviews | Thematic analysis | 2.57 |
| Inpatient specialist palliative care providers (physicians, nurses, spiritual support counselor), 2020–2021 | Sena | 2022 | To explore palliative care health professionals and physicians perceptions of end-of-life care management in COVID units during the first two waves of the pandemic | Italy, hospitals | Convenience sampling | Semi-structured interviews | Thematic analysis | 3.23 |
| Inpatient specialist palliative care providers clinicians (physicians, nurses, physiotherapist, psychologist, pharmacist), 2020 | Tavares | 2021 | To explore the main challenges in providing PC during a pandemic and describe the strategies to be adopted to solve the identified difficulties | Portugal, urban academic hospital | Convenience sampling | Open-ended survey questions | Content analysis | 0.51 |
| Inpatient specialist palliative care providers (physicians, volunteer palliative care consultants), 2021 | Tong | 2022 | To understand the experiences of remote volunteer palliative care consultants during the initial COVID-19 surge | USA, urban academic hospital | Purposive sampling | Semi-structured interviews | Thematic analysis | 4.20 |
|
Inpatient specialist palliative care providers (physicians, nurses, consultants, residents), not reported Non-inpatient palliative care clinicians (nurses, physiotherapists, acute medicine consultants, respiratory consultants), not reported |
Wenzel | 2022 | To explore the experiences of healthcare workers providing non-invasive advanced respiratory support (NARS) to critically unwell patients with COVID-19 | UK, acute national health service trust across two hospitals | Purposive sampling | Semi-structured interviews | Thematic analysis | 1.29 |
|
Inpatient specialist palliative care providers (medical or nursing directors, other), 2020 Non-inpatient palliative care clinicians (medical or nursing directors, other) 2020 |
Bradshaw | 2021 | To describe the challenges UK specialist palliative care services experienced regarding advance care planning during COVID-19 and changes made to support timely conversations | UK, services providing specialist palliative care (inpatient palliative care, hospital palliative care, home palliative care, home nursing) | Purposive sampling | Cross-sectional online survey | Framework analysis | 3.08 |
|
Inpatient specialist palliative care providers (physicians, nurses) 2021 Non-inpatient palliative care clinicians (family members), 2021 |
Collier | 2022 | To investigate the experiences of any person — for example, patients, families and clinicians of restrictions to hospital visits for people with palliative and end-of-life care needs during COVID-19 restrictions in New Zealand | New Zealand, tertiary hospital | Purposive and snowball sampling | Semi-structured interviews | Not reported | 1.32 |
|
Inpatient specialist palliative care providers (medical directors, lead medical clinicians, nursing directors), 2020 Non-inpatient palliative care clinicians (medical directors, lead medical clinicians, nursing directors), 2020 |
Dunleavy | 2020 | To map and understand specialist palliative care services innovations and practice changes in response to COVID-19 | Global, services providing palliative care (inpatient palliative care, hospital palliative care, home palliative care, home nursing) | Purposive sampling | Online survey | Framework analysis | 4.95 |
|
Inpatient specialist palliative care providers (physicians), 2020 Non-inpatient palliative care clinicians (physicians), 2020 |
Gips | 2022 | To describe the perceived qualities of successful palliative care (PC) providers in the emergency department (ED), barriers and facilitators to ED–PC, and clinicians’ perspectives on the future of ED–PC | USA, urban academic EDs | Homogenous purposive | Semi-structured interviews | Two-step rapid analysis | 0.366 |
|
Inpatient specialist palliative care providers (physicians, nurses, social workers, chaplains, resident), 2020 Non-inpatient palliative care clinicians (nurses, consultants), 2021 |
Hanna | 2021 | To explore health and social care professionals’ experiences and perceptions of providing end-of-life care during the COVID-19 pandemic | UK, range of clinical settings (hospital care-home) | Purposive sampling | Semi-structured interviews | Thematic analysis | 1.63 |
|
Inpatient specialist palliative care providers (social workers), 2020 Non-inpatient palliative care clinicians (social workers), 2020 |
Latimer | 2022 | The main objectives of this study were (1) to assess palliative and hospice social workers’ experiences of moral distress during COVID-19 and (2) to identify and describe participants’ most morally distressing scenarios | USA, social work hospice palliative care network members | Snowball sampling | Online questionnaire | Thematic analysis | 1.13 |
|
Inpatient specialist palliative care providers (nurse, palliative consultants), 2020 Non-inpatient palliative care clinician (infection control nurse, consultant, anesthetist), 2020 |
Mitchinson | 2021 | To identify barriers to delivering end-of-life care, describe attempts to deliver care during the COVID-19 pandemic, and understand the impact this had on staff | UK, large teaching hospitals | Purposive sampling | Semi-structured interviews | Framework analysis | 0.647 |
|
Inpatient specialist palliative care providers (physician, nurses), 2020 Non-inpatient palliative care clinicians (pharmacist, supply chain and environmental service workers), 2020 |
Navuluri | 2023 | To understand the contours of distressed work faced by healthcare professionals during COVID-19 | USA, quaternary referral hospital | Purposive sampling | Semi-structured interviews and participant observations | Thematic analysis | 3.96 |
|
Inpatient specialist palliative care providers (physicians, nurses, administrative staff, other), 2020 Non-inpatient palliative care clinicians (physicians, nurses, administrative staff, other), 2020 |
Oluyase | 2020 | To study the response of and challenges for palliative care services during the COVID-19 pandemic | Global, specialist palliative care services (hospital, community-home based, nursing home) | Purposive sampling | Free-text questions in survey | Content analysis | 0.278 |
|
Inpatient specialist palliative care providers (physicians, nurses, psychologists, medical managers), 2020 Non-inpatient palliative care clinicians (nurses), 2020 |
Seibel | 2022 | To explore the experiences of stakeholders and staff in implementing and operating an ad hoc unit delivering acute palliative care | Germany, urban academic hospital | Purposive sampling | Semi-structured interviews | Content analysis | 1.13 |
|
Inpatient specialist palliative care providers (unknown), 2020 Non-inpatient palliative care clinicians (unknown), 2020 |
Singh | 2022 | To explore health professionals’ perspectives of the role of palliative care during the COVID-19 pandemic by analyzing their views and experiences expressed in articles and blogs located via Twitter | Convenience and/or snowball sampling | Online opinion articles (Tweets) | Content analysis | 1.09 | |
|
Inpatient specialist palliative care (physicians, internists), 2020–2021 Non-inpatient palliative care clinicians (physicians) 2020–2021 |
Wentlandt | 2022 | To explore the facilitators and barriers to palliative care integration in the care of patients with COVID-19 | Canada, primary, secondary, tertiary hospitals | Purposive and snowball sampling | Semi-structured, open-ended interview | Thematic analysis | 3.54 |
|
Inpatient specialist palliative care providers (physician), 2020–2021 Non-inpatient palliative care clinicians (physicians) 2020–2021 |
Wentlandt | 2023 | To describe physician experiences with (restrictive visitor) policies and reflections of their effects | Canada, primary, secondary, and tertiary hospitals | Snowball sampling | Semi-structured interviews | Template analysis | 4.45 |
|
Inpatient specialist palliative care providers (physician), 2020 Non-inpatient palliative care clinicians (physicians, nurse practitioner) 2020 |
Wiebe | 2021 | To document how the experience of providing medical assistance in dying (MAiD) changed during the COVID-19 pandemic | Canada, MAiD providers and coordinators | Convenience, purposive, and snowball sampling | Semi-structured interviews | Abductive reasoning | 1.41 |
|
Inpatient specialist palliative care providers (physicians, nurses, consultants, residents), not reported Non-inpatient palliative care clinicians (nurses, physiotherapists, acute medicine consultants, respiratory consultants), not reported |
Wenzel | 2022 | To explore the experiences of healthcare workers providing non-invasive advanced respiratory support (NARS) to critically unwell patients with COVID-19 | UK, acute national health service trust across two hospitals | Purposive sampling | Semi-structured interviews | Thematic analysis | 1.29 |
| Non-inpatient palliative clinicians (physician), 2020 | Aaronson | 2020 | To evaluate emergency department (ED) clinician’s experiences on embedding palliative care (PC) in the ED during COVID-19 | USA, urban academic ED | Voluntary response sampling | Survey | Inductive thematic analysis | 1.32 |
| Non-inpatient palliative clinicians (general public), 2019–2020 | Back | 2021 | To understand public perceptions of serious illness care to inform greater public engagement | USA, general public | Third-party recruitment | Focus groups | Not reported | 0.154 |
| Non-palliative clinicians (hospice medical directors, hospice directors of nursing), 2020 | Constantini | 2020 | To examine the preparedness for, and impact of, the COVID-19 pandemic on hospices in Italy to inform the response in other countries | Italy, hospices | Purposive sampling | Telephone interview | Descriptive analysis | 0.281 |
| Non-inpatient palliative care clinicians (hospice staff, family members), 2020 | Cross | 2022 | To explore how hospice admissions staff and caregivers of hospice patients perceive the hospice admission process and the transition to hospice at home | USA, hospice organization | Purposive sampling | Semi-structured interviews | Thematic analysis | 2.44 |
| Non-inpatient palliative care clinicians (directors of nursing), 2021 | Ninteau | 2022 | To capture how nursing homes addressed palliative care needs during the pandemic | USA, community nursing homes | Snowball sampling | Semi-structured interviews | Thematic analysis | 1.87 |
| Non-inpatient palliative care clinicians (physicians, nurses), 2020 | Schallenburger | 2022 | To examine challenges and possible solutions for general palliative care inpatients in relation to the care of seriously ill and dying patients and their relatives | Germany, primary, secondary, tertiary hospitals | Convenience sampling | Focus groups | Content analysis | 1.23 |
| Non-inpatient palliative care clinicians (physicians, hospital leader, spiritual care provider), 2020 | Vesel | 2021 | To explore the utilization, perceptions, and understanding of palliative care among critical care clinicians, hospital leaders, and spiritual care providers during the pandemic | USA, tertiary academic medical center | Purposive sampling | Semi-structured interviews | Thematic analysis | 3.39 |
| Non-inpatient palliative care clinicians (general public), 2020 | Vihvelin | 2022 | To gain insight into preferences for the end-of-life and end-of-life care from people experiencing homelessness | Canada, general public | Purposive sampling | Semi-structured telephone interviews | Thematic analysis | 0.179 |
| Non-inpatient palliative care clinicians (clinical oncologists), 2021–2022 | Wang | 2022 | To explore the current status of palliative care practice for cancer and the influence of COVID-19 from the perspective of oncologists | China, various settings (medical centers, palliative care institutions) | Not reported | Semi-structured interviews | Thematic analysis | 0.578 |
*Voices we abstracted for our study